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Post by Admin on Jun 1, 2020 4:54:50 GMT
Why Mental Health is a Human Right www.madinamerica.com/2020/05/mental-health-human-right/From The New Statesman: “In his 2017 and 2019 reports on mental health [to the United Nations], Puras outlined what he believes are systemic problems across the world: pathologisation, overmedicalisation, an overly dominant disease-oriented ‘biomedical model’, and high levels of coercion in psychiatric care. Puras hammered home his belief that a rights-based approach, which also addresses social determinants of mental health – such as inequality and social exclusion – would be better for the world’s wellbeing. ‘Inequality is a key obstacle to mental health globally,’ he wrote in 2019. ‘Many risk factors for poor mental health are closely associated with inequalities in the conditions of daily life. Many risk factors are also linked to the corrosive impact of seeing life as something unfair.'” www.newstatesman.com/spotlight/healthcare/2020/05/why-mental-health-human-right
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Post by Admin on Jun 5, 2020 17:24:24 GMT
Canadian Mental Health Legislation and the CRPD The Mad Canada Shadow Report Group tells the UN that Canada is not complying with the United Nations Convention on the Rights of Persons with Disabilities. "We want Canadian lawmakers to start doing what they promised to do, which includes having persons with psychosocial disabilities lead the change from psychiatric oppression to supports that people actually want." www.madinamerica.com/2020/06/canadian-mental-health-legislation/
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Post by Admin on Jul 7, 2020 15:44:31 GMT
A Rights-Based Approach to Mental Health Crisis ResponseA new article describes nine critical elements to a human rights-based approach to mental health crisis response. A new article, published in the Health and Human Rights Journal, describes, for the first time, the critical elements to a rights-based approach to mental health crisis response. The authors identify the normative framework of a rights-based approach, specify the key principles and values, and enumerate the elements in crisis response practices that embody a human rights framework. The fundamental principles that guided the authors’ rights-based approach are participation and empowerment, equality and non-discrimination, quality and diversity of care, social inclusion, autonomy, and dignity. The researchers, led by Peter Stastny, a psychiatrist and founding member of the International Network Towards Alternatives and Recovery, write: “The key principles that guide the identification of the critical elements for rights-based mental health care are selected here because they can eliminate substitute decision-making and promote self-determination for individuals within crisis response and systems of mental health support. Without these assurances, crisis situations, whether gradually or rapidly evolving, are likely to result in the immediate and sustained infringement of human rights.” www.madinamerica.com/2020/07/rights-based-approach-mental-health-crisis-response/Crisis Response as a Human Rights Flashpoint: Critical HHR_final_logo_alone.indd 1 10/19/15 10:53 AM Elements of Community Support for Individuals Experiencing Significant Emotional Distress peter stastny, anne m. lovell, julie hannah, daniel goulart, alberto vasquez, seana o’callaghan, and dainius pūras Abstract This paper proposes a set of nine critical elements underpinned by human rights principles to support individuals experiencing a serious crisis related to mental health problems or psychosocial disabilities. These elements are distilled from a range of viable alternatives to traditional community mental health approaches and are linked to a normative human rights framework. We argue that crisis response is one of the areas of mental health care where there is a heightened risk that the rights of service recipients may be infringed. We further make the case that the nine critical elements found in advanced mental health care models should be used as building blocks for designing services and systems that promote effective rights-based care and supports. cdn1.sph.harvard.edu/wp-content/uploads/sites/2469/2020/06/Stastny.pdf
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Post by Admin on Jul 8, 2020 14:40:35 GMT
We are very excited to announce that our newest CE presentation, "A Rights-Based Approach to Global Mental Health: Time for a Paradigm Change," is now freely accessible on our MIACE website. This program will include a presentation of the following: ●Description of a rights-based approach to mental health and an introduction to the work of the United Nations (UN) Special Rapporteur Dainius Puras. ●Review of the Movement for Global Mental Health and the major critiques of this initiative. ●Overview of steps practitioners can take to move the field toward rights-based mental health care. ●Envisioning a paradigm change and conceptualizing the “global burden of obstacles” to rights-based care To register, click below. education.madinamerica.com/p/a-new-view-of-global-mental-healthAbout This Course In this presentation, Lisa Cosgrove, Ph.D, discusses the controversies and criticisms of the global mental health movement. Drawing upon the work of U.N. Special Rapporteur for Health, child psychiatrist Danius Puras, it offers suggestions for a rights-based approach to mental health. Course fee This course is for free. If you find this course useful, please consider making a donation to help support our work.
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Post by Admin on Jul 18, 2020 15:23:12 GMT
A new article, published in the Health and Human Rights Journal, analyzes important barriers to the implementation of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and proposes ways to move away from the bio-medical model toward an epistemology and set of practices based on collective first-person knowledge. The article is written by experts in survivor-controlled research and critical disability studies, Jasna Russo, from the Technical University Dortmund, Germany, and Stephanie Wooley, from the European Network of (Ex-)Users and Survivors of Psychiatry. “The fact that our collective first-person knowledge has not yet amounted to our own model or theory but remains subject to expert interpretations makes us continue to seek better explanations of our own lives and leaves us without a self-articulated framework to understand and communicate our social realities beyond our individual stories,” Russo and Wooley write. The CRPD and the Need for New Model of Madness and Mental Distress The full implementation of the Convention on the Rights of Persons with Disabilities requires a model created by those with first-hand knowledge of madness and distress. www.madinamerica.com/2020/07/crpd-need-new-model-madness-mental-distress/The Implementation of the Convention on the Rights of Persons with Disabilities: More Than Just Another Reform of Psychiatry jasna russo and stephanie wooley Abstract The social model of disability—which is grounded in the lived realities of disabled people, as well as their activism, research, and theoretical work—has enabled a historic turn in the understanding of disability. This model also facilitates the transition to the rights-based approach that is at the core of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). However, the social model of disability does not straightforwardly translate to the lives of people who end up being detained and forcibly treated in psychiatric facilities. This paper examines the implications of the lack of an equivalent theoretical framework to counteract the hegemony of the biomedical model of “mental illness” and to underpin and guide the implementation of the CRPD for people with psychiatric diagnoses. Critically engaging with some recent attempts to make the CRPD provisions integral to psychiatry, we expose fundamental contradictions inherent in such projects. Our discussion seeks to extend the task of implementation of the CRPD beyond reforming psychiatry, suggesting a much broader agenda for change. We argue for the indispensability of first-person knowledge in developing and owning this agenda and point to the dangers of merely remaking former treatment objects into objects of human rights. cdn1.sph.harvard.edu/wp-content/uploads/sites/2469/2020/06/Russo-Wooley.pdf
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Post by Admin on Jul 18, 2020 23:22:12 GMT
Health & Environmental Rights Health care and a healthy environment is a human right for prisoners and non-prisoners alike. Inadequate or non-existent mental health and medical care inside of prisons is a systemic problem that has impacts beyond the walls of the prison. Prisoners are vulnerable to other health risks as well. Economically depressed towns are frequently sites for toxic industries and prisons. This puts prisoners at an increased risk of harmful health impacts from polluted air and water. abolitionistlawcenter.org/docket-areas/health-environmental-rights/About - abolitionistlawcenter.org/about/The Abolitionist Law Center is a public interest law firm inspired by the struggle of political and politicized prisoners, and organized for the purpose of abolishing class and race based mass incarceration in the United States. Abolitionist Law Center litigates on behalf of people whose human rights have been violated in prison, educates the general public about the evils of mass incarceration, and works to develop a mass movement against the American punishment system by building alliances and nurturing solidarity across social divisions. The Abolitionist Law Center is based on years of practical experience fighting for prisoners’ rights, particularly through the work of the Human Rights Coalition. Founded in 2000 by Pennsylvania state prisoners (including ALC Director of Community Organizing Robert Saleem Holbrook who was in SCI Huntingdon at the time) the Human Rights Coalition has been a leader in exposing torture and other human rights violations inside Pennsylvania’s prison system. Bret Grote, the Legal Director and co-founder of the Abolitionist Law Center, has worked as a volunteer with the Human Rights Coalition since 2007. The Abolitionist Law Center continues to work closely with the Human Rights Coalition and other allies in pursuing our shared vision of prison abolition and social justice. Working with prisoners in defense of human rights has led us to the realization that the prison system – and, in particular, its reliance on solitary confinement – is part of a larger system that operates according to a logic of violence and intimidation. Solitary confinement is used to terrorize the prisoner population. The prison population and policies of race and class based mass imprisonment are used to terrorize poor communities in general, and communities of color in particular. And the socio-economic conditions in those communities are used to keep relatively privileged communities in line and focused on carrying out the agenda of a powerful few. The Abolitionist Law Center seeks to challenge this status quo by building creative, principled, visionary, and lasting alliances with people and organizations inside and outside of prison who are determined to confront and defeat these interconnected systems of oppression, and replace them with healthy, sustainable, and liberating alternatives.
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Post by Admin on Jul 18, 2020 23:26:48 GMT
Dying With Her Rights On nationalshatteringsilencecoalition.org/blog/dying-with-her-rights-onWhy Do Laws Deny the Most Seriously Ill Their Right to Live? “They should have let you help me. I wasn’t in my right mind.” Those words will haunt me until the end of my days. Those words are why I believe that treatment providers must listen to and consider families’ input. Families, regardless of whether they have legal guardianship, should have the right to intervene and get their loved ones into treatment when they see the need. Those who love them most are the ones who see the signs first and most clearly. Those words are why I believe that so many people who are left to “die with their rights on” are, in truth, denied their right to live by our current restrictive laws. Ann’s wise words have been my inspiration for years. Her last words to me continue to inspire me to fight for treatment for people with serious brain disorders, who are unable to help themselves. “They should have let you help me. I wasn't in my right mind.”
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Post by Admin on Jul 20, 2020 18:51:57 GMT
Petition Abolish the Mental Health Act and legislate for new forms of support The Mental Health Act is one of the few areas of law where individuals can be detained against their will despite having committed no crime, and given medical treatment without their consent. This appears inconsistent with both the Equality Act and Human Rights Act. petition.parliament.uk/petitions/317620
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Post by Admin on Aug 3, 2020 13:01:52 GMT
No Mental Health Without Human Rights An Analysis of the UN Special Rapporteur's Recent Report By Adishi Gupta -July 29, 2020 madinasia.org/2020/07/no-mental-health-without-human-rights-an-analysis-of-the-un-special-rapporteurs-recent-report/Since the last few months, the world has been witnessing increasingly challenging times on various fronts, triggered in part by the COVID-19 pandemic. There have been, and continue to be, numerous instances of violence and injustice against the vulnerable and the marginalised. It is also important to add here that most of this violence has been an everyday reality for scores of people around the world since even before the pandemic. However, the mishandling of the pandemic by various governments has only added to those instances manyfold. In these times of crises, it has become even more imperative to foreground conversations and measures focused on the promotion and protection of all human rights. In this light, we are delighted to see that the latest report by the UN Special Rapporteur (SR), Dr Dainius Pūras, adopted in the 44th session of the Human Rights Council of the United Nations is distinctive in declaring that, “There is no mental health without human rights”. In this new report, he calls for worldwide measures to ensure the “right of everyone to the enjoyment of the highest attainable standard of physical and mental health.” Dr Pūras has previously appealed for the need to “abandon the predominant medical model that seeks to cure individuals by targeting ‘disorders.'” In this new report, he presses upon the importance of the “promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development”. This report is also perhaps the document most strongly endorsing the UNCRPD. He urges us to look at how the Movement for Global Mental Health (previously known as Global Mental Health) is framed and delivered because it will have a huge impact on whether human rights are upheld or not. The Movement for Global Mental Health (MGMH) aims to scale up access to mental health services, and to a wider field of advocacy, activism and research, including critical perspectives. The fact that the SR is referring to a better framing ensuring human rights tells us that there are areas for concern in the way the MGMH is currently being delivered and needs thought and change. In addition, he speaks about the need to critically assess which policies may work in certain areas and contexts and that we can’t simply ‘export’ advocacy strategies and other literature from the Global North to the South. He stresses the importance of moving away from standardisation for global mental health, “while standardization is important for global work, it also overlooks understanding and practices that resist standardization owing to complexity or locality.” As user-survivors from the Asia Pacific region, it is of utmost significance for us that global guidelines are not universally applied to our context, without due consideration given to our social realities. The SR suggests: A rights-based pathway to achieving more local relevance in global mental health might be to move away from evidence-based practice to practice-based evidence, which takes as its starting point local realities, possibilities and understanding of care. Research shows that mental health system reform in fragile and conflict-affected areas emerges through creative practices, experimentation, adaptation and the application of knowledge, as people deal with uncertainty and complexity in contexts where fundamental resources are sometimes lacking. This is exciting for us because it puts rights at the forefront of all action while asking us to move from evidence-based (read medical) to practice-based (read community-led, local) evidence. The SR quotes TCI Asia Pacific’s Bali Declaration of 2018 that “affirmed the need for a paradigm shift in mental health towards inclusion and away from a focus dominated by the medical model” and was similar to the approach shared by other organisations such as Mental Health Europe. Several organisations share this advocacy approach about moving towards non-medical alternatives and these voices add to the global conversation asking for a shift from more medical services to other culturally relevant, community-focused, and trauma-informed means of enhancing what health may mean to individuals. The SR’s report firmly states that human rights violations, perpetuating coercion, stigma and discrimination against persons with disabilities, are all still happening due to practices existing within the field of mental health and that it is imperative to work towards changing these oppressive structures. Mental health systems worldwide are dominated by a reductionist biomedical model that uses medicalization to justify coercion as a systemic practice and qualifies the diverse human responses to harmful underlying and social determinants (such as inequalities, discrimination and violence) as “disorders” that need treatment. In such a context, the main principles of the Convention on the Rights of Persons with Disabilities are actively undermined and neglected. This approach ignores evidence that effective investments should target populations, relationships and other determinants, rather than individuals and their brains. It is commendable that the report engages with the power imbalance entrenched in the mental health space and the importance of “the participation of persons with mental health conditions, including persons with disabilities, in the planning, monitoring and evaluation of services, in system strengthening and in research.” The combination of a dominant biomedical model, power asymmetries and the wide use of coercive practices together keep not only people with mental health conditions, but also the entire field of mental health, hostage to outdated and ineffective systems. States and other stakeholders, specifically the professional group of psychiatry, should critically reflect on this situation and join forces already on the way towards abandoning the legacy of systems based on discrimination, exclusion and coercion. The SR cautions against “over-medicalisation” while reflecting on the labels that are assigned based on “enforced boundaries around normal or acceptable behaviours and experiences.” He affirms that medicalised responses to social exclusion and discrimination “can often disproportionately affect individuals who face social, economic or racial marginalisation.” Medicalization can mask the ability to locate one’s self and experiences within a social context, fuelling misrecognition of legitimate sources of distress (health determinants, collective trauma) and producing alienation. In practice, when experiences and problems are seen as medical rather than social, political or existential, responses are centred around individual-level interventions that aim to return an individual to a level of functioning within a social system rather than addressing the legacies of suffering and the change required to counter that suffering at the social level. Moreover, medicalization risks legitimizing coercive practices that violate human rights and may further entrench discrimination against groups already in a marginalized situation throughout their lifetimes and across generations. He, thus, appeals to move away from “individual-level interventions” by critically reflecting on the exclusionary and discriminatory social structures that cause distress. This is an important point, one that urges us to stop looking at individuals through an illness lens, from a what is wrong with you lens, to a societal lens – what may have happened to make this individual feel or react this way? This is exciting to us at Mad in Asia Pacific where we work to bring awareness to this social justice model. In order to prevent mass medicalization, it is essential to embed a human rights framework in the conceptualization of, and policies for, mental health. The importance of critical thinking (for example, learning about the strengths and weaknesses of a biomedical model) and knowledge of the importance of a human rights-based approach and the determinants of health must be a central part of medical education. The SR acknowledges that mental health-care systems and institutions are failing and that there are other approaches to look at the right to health. He looks towards innovative community projects that focus on building strength and resilience in the communities, allowing for diversity, and acceptance of varying versions of ‘normal’. Several sections of the report also emphasise the importance of engaging with persons with lived experience and ask for the acceptance of diverse communities with a variety of experiences. Action that focuses only on strengthening failing mental health-care systems and institutions is not compliant with the right to health. The locus of the action must be recalibrated to strengthen communities and expand evidence-based practice that reflects a diversity of experiences. He demands an “immediate scaling-up of rights-based, non-coercive alternatives” that are “occurring in neighbourhoods and communities worldwide” operating with a “deep commitment to human rights, dignity and non-coercive practices, all of which remain an elusive challenge in traditional mental health systems too heavily reliant on a biomedical paradigm.” The SR also urges for critical and sustained engagement with factors like climate change, digital surveillance and the current COVID-19 pandemic situation and their effects on global mental health. He writes that the “emotional and existential realization of the magnitude of the climate problem” is increasingly being experienced particularly by children and young people. Additionally, he talks about the curtailment of people’s rights and the significant harm that “non-transparent surveillance” of people by State or non-State actors can bring to people’s mental health. Finally, the SR concludes the report with a set of important conclusions and recommendations, firmly declaring that “There is no health without mental health and there is no good mental health and well-being without embracing a human rights-based approach”. The report’s holistic and interdisciplinary engagement with mental health fills us with immense hope about a more just and equitable world and we at Mad in Asia Pacific fully endorse it. You can download the Word and PDF versions of the full report in English and several other languages here - undocs.org/en/A/HRC/44/48Drafted with inputs from Jhilmil Breckenridge.
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Post by Admin on Sept 19, 2020 19:33:02 GMT
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Post by Admin on Sept 22, 2020 20:34:39 GMT
We Need a More Humane Word for Mental Illness www.youtube.com/watch?v=cdzmgxdTrwQA Human Rights declaration by modern mystic, Spencer Perdriau, justly stating the need to find a new humane word for mental illness, and the every-day struggles of life that a person faces with such, such as the many prejudices and stigmas from society and others that greatly limit the potential and productiveness of those struck by this.
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Post by Admin on Sept 23, 2020 21:41:43 GMT
Equal Rights for All But the Mentally Ill kristinarolfes.com/?p=254Of all the groups that have faced discrimination in our country’s history, one group stands alone. People with serious mental illness are the only group in which discrimination is still not only socially acceptable, but perfectly legal. Unless you have experienced mental illness in your family, you may be unaware of all the ways this discrimination exists. People with brain illnesses like schizophrenia and bipolar disorder are routinely denied medically necessary treatment based solely on their disability type. One way this happens is through laws that withhold treatment until the person has deteriorated to the point of dangerousness. When a person is experiencing a mental illness crisis, they will be turned away by the hospital unless they have threatened to harm others or have a plan to kill themselves. A person who does not meet the “danger” standard is left to deteriorate further. The longer psychosis is left untreated, the more damage occurs to the brain, and the worse their chances for recovery. If a family does manage to get their loved one admitted for treatment, the person is inevitably discharged before they are medically stable. You need look no further than the daily headlines to see this play out again and again. Take this example: Three attacks linked to mental illness in 30 days leave five dead in Metro Detroit. Both the police and families sought treatment for the individual, and each time, they were released much too soon and with no follow-up. Not surprisingly, things ended in tragedy. Untreated mental illness results in danger, crime and tragedy—every day and in communities all across the country. And we let it happen over and over again. Not only does withholding treatment violate a person’s rights, but it also puts their families, the police and the public in danger. Why do we allow it? We would never tell someone with cancer, “You are only in stage II, so we can’t treat you. Come back when it’s progressed to stage IV,” or say to a diabetic, “We can’t treat you until you are in a diabetic coma.” These scenarios are unthinkable, yet have become normalized in mental illness. It is morally wrong to deny treatment to any group based on their disability, so why is there an unspoken carveout for the mentally ill? Denying treatment to this group is blatant discrimination, yet it is somehow acceptable to doctors, hospital leaders, politicians and the general public. Why is one group of disabled people deemed less worthy than others? Is a person with autism or brain cancer more worthy than a person with schizophrenia? Is a person with Parkinson’s or dementia more valuable than a person with bipolar? All are people with brain illnesses. All deserve the right to receive medically necessary treatment. No exceptions. If you believe in equal rights for people with brain illnesses, please consider joining the National Shattering Silence Coalition. NSSC speaks out about federal, state and local policies that impact adults and children living with serious brain disorders commonly referred to as “serious mental illness” and advocates for change.
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Post by Admin on Dec 2, 2020 20:04:27 GMT
It's no wonder disability rights legislation has failed, writes Ellen Clifford, when the very category of disability is essential to upholding capitalism. Disabled people will never be gifted full equality under a system that, in order to justify itself, needs them to have a worse experience of life than those better suited for exploitation. 25 Years on From the Disability Discrimination Act, Disabled People Still Face Oppression and Injusticeby Ellen Clifford @ellenclifford1 2 December 2020 novaramedia.com/2020/12/02/25-years-on-from-the-disability-discrimination-act-disabled-people-still-face-oppression-and-injustice/The theme of this year’s Disability History Month – access – throws a spotlight on how far we’ve come towards disability equality, but also on what is still left to be done. Access may seem a strange choice of theme to a non-disabled audience, particularly after the dramatic year we’ve just been through, but the word is key to disabled people and central to the fight for our rights. In order to be free of injustice and oppression, we must have equal access to the same opportunities as non-disabled people. The access theme was chosen to mark 25 years since the passage of the Disability Discrimination Act (DDA) but it is also sharply relevant to experiences during the pandemic when disabled people have had to fight for – and been denied – equal access to healthcare. Heralded in 1995 as groundbreaking disability anti-discrimination legislation, over time it has become apparent just how limited the DDA – and later the Equality Act 2010 – is in guaranteeing equal access for disabled people and protecting us from injustice. This has been underlined not only by Covid-19 but, before that, by austerity and welfare reform. Disabled people unquestionably have greater opportunities now than before the DDA. The legislation established a duty now enshrined in the Equality Act 2010 to provide “reasonable adjustments” to grant access to individual disabled people who would otherwise be excluded from jobs and other opportunities. The comedian Rosie Jones told BBC Question Time last month that her life had “without a doubt” been better because it had allowed her to go to university and get a job. This resonates with my own experiences. I remember before the DDA and I know I wouldn’t have survived in the workplace without a legal right to reasonable adjustments. But the legislation still doesn’t go nearly far enough, with individual disabled people frequently having to personally defend their legal rights, before then fighting to have their individual access needs met. Equality of opportunity for disabled people is not simply a case of overcoming stigma and barring exclusion on attitudinal grounds. There are also potentially hefty sums involved in guaranteeing access for disabled people – hence the legal qualification that required adjustments must be no more than “reasonable” to the party incurring the cost. The government’s access to work scheme can cover certain additional costs involved in employing a disabled person, but, since 2013, individual awards have been tightened. Employers can also be resistant to adjustments that require changes to organisational practice – especially when bosses feel allowing special dispensations for disabled staff could undermine measures that raise workers’ productivity and lessen their autonomy. The limitations of anti-discrimination legislation. Anti-discrimination law was not what the disabled people’s movement of the 1980s and early 1990s campaigned for. Their goal was civil rights legislation. The DDA came into being as a quirk of fate when then-minister for disabled people Nicholas Scott was exposed by his own daughter, disability rights campaigner Victoria Scott, as having lied in parliament about the cost of implementing a civil rights bill. Today government ministers such as Esther McVey routinely lie in parliament, but back then it was considered shameful. By way of recompense, the Conservative government introduced the DDA. One of the key criticisms of both the DDA and the Equality Act is that they must be enforced by individual disabled people. A lords committee investigating the impact of the Equality Act on disabled people in 2016 expressed frustration with the government’s failure to take responsibility for disabled people, concluding: “Rights which are unenforceable are not worth having.” Similarly, while the Equality Act has been used to hold back some of the damaging welfare reforms and austerity measures the government has tried to introduce since 2010 – on the grounds that due regard has not been paid to the impact on people with protected characteristics – its impact has been limited by the fact that legal challenges can only be initiated by an individual directly affected and within a narrow three-month window. These limitations place an enormous burden on disabled people and often mean that much unlawful policy is implemented without challenge. The fact that the due regard duty is often the strongest option open to campaigners, itself says something about the lack of available protections. And while ministerial decisions taken without due regard can be quashed by the high court, the government is then free to simply retake the decision. This happened with the closure of the independent living fund, a source of essential daily living support for disabled people living in the community. A second legal challenge against the new decision was dismissed in 2014 on the grounds that this time the relevant minister “was very well aware… that the impact would be substantial and significant”. The need for transformation. The failure of rights legislation to free disabled people from injustice and oppression should come as no surprise. The very category of disability owes its existence to the rise of capitalism and the need to identify those of us who are less productive; the system depends upon us having a worse experience of life than those better suited for exploitation. Fear of undermining the work incentive is one substantial reason why full equality will never be gifted to us. As the disabled American socialist Marta Russell write: “Civil rights incrementalist history tells us that it may not be so wise to rely on a system to generate equality when that system’s goals – increasing concentration of private and corporate ownership – are in conflict with principles of equality.” Rights legislation helps individual disabled people to be accepted into and survive within society as it stands. It can also provide compensation for victims of specific cases of discrimination. But when it comes to the socio-economic structures from which disabled people’s oppression flows, legislation won’t provide the level of change that we need. For that, we need radical transformation. Ellen Clifford is a disabled activist and author of The War on Disabled People: Capitalism, Welfare and the Making of a Human Catastrophe published by Zed Books. Ellen will be co-hosting an evening of politics, conversation, music and laughter with DPAC, People’s Assembly and guests including John McDonnell, to mark International Day of Disabled People on Thursday 3 December 2020, from 7pm – 9.30pm. Join her on Facebook Live, Twitter or YouTube.
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Post by Admin on Dec 3, 2020 19:02:15 GMT
Madness and the Disability Discrimination Act – forget discrimination, it is now abject brutalityMental distress is not a health issue, it is political to its core, argues DENISE McKENNA morningstaronline.co.uk/article/f/madness-and-disability-discrimination-act-forget-discrimination-it-now-abject-brutalityASOCIAL model of madness is concerned with identifying the social causes of mental distress and fighting for a society in which people who live with such distress can flourish. The disabled people’s movement used the social model of disability to campaign against social barriers encountered by people with physical impairments. They identified these barriers, rather than the impairment, as being the cause of disability. Attempts to replicate the social model of disability for mental health have been complicated because societal abuses are implicated in the creation of the distress. This distress might be called the impairment and precedes any disabling barriers society imposes. Unravelling society’s role in creating mental distress is impeded by psychiatry’s monopoly on defining madness, its causes and treatment. Psychiatry’s authority is reified in the Mental Health Act. Currently most NHS treatments consist of drugs and positive psychology. Cognitive behavioural therapy (CBT) purportedly provides self-help tools for recovery and the recovery model measures progress. However, the areas of life to be addressed and our goals are chosen for us, not by us, and are clearly aimed at bringing our thinking into line with the demands of capitalism. It tastes like brainwashing. In 2002, then Tory leader Iain Duncan Smith visited Easterhouse in Glasgow, a housing estate I knew from my childhood in the 1960s to be a functioning and lively working-class community. Duncan Smith’s theatrical visit showed him misty-eyed, apparently saddened by the torpor of the residents who had allowed themselves and their environment to go to seed. This was not the Easterhouse I remembered. What had happened? At an informed guess I would say Thatcherism had happened; a Thatcherism in which Duncan Smith was deeply complicit. In what resembles a case of Munchausen syndrome by proxy, Duncan Smith rushed to the scene of the crime to announce himself saviour. Somewhat predictably, he concluded that the social security system encouraged fecklessness. Eight years later, as secretary of state for work and pensions, Duncan Smith began to remove disability benefits without mercy, leaving many people destitute and others dead. This atrocity continues today. The Five Year Forward View for Mental Health, 2014, claimed that work improved mental health and anything that would push someone into work was a valid intervention or treatment. We call this the work cure. Being in work would be evidence of the efficacy of the cure, since work now signalled wellness, an idea made nonsense of by the fact that mental distress amongst people in work is endemic. The patient in need of care had been transmogrified into society itself and “worklessness” was the disease that was afflicting it. As the mad person was now no longer the patient, care could be withdrawn, other than some workplace positive thinking. In all of this chicanery, the major mental health charities have collaborated with the government, even taking a lead, winning contacts and honours for senior personnel. The psychiatric profession might argue that the financial predicament of their patients lies outside of their domain but this would be disingenuous because they know Improving Lives: The Future of Work, Health and Disability Paper, 2017, brings together the NHS and Department for Work and Pensions and this conflation now informs mental healthcare practices. Disabled people protested against this merging but there was no murmur of protest from psychiatric professional bodies. I attended a conference where senior psychiatrists promoted treatments according to how quickly they could get people into work. The psychiatric profession has acted in bad faith by colluding with an extreme political ideology which harms their patients. Despite well-intentioned individual psychiatrists, psychiatry is now a debased profession. However, psychiatry itself is in a predicament. Increasingly trauma is being identified as a major cause of madness, often arising from abuse, yet everywhere in our culture, from the exploitation of humans, animals and all of nature at the heart of extractive capitalism, to the everyday domestic violence of patriarchy, trauma is there. How can a doctor treat a patient for burns when both doctor and patient are sitting together in the flames? I suggest that mental distress is not a health issue, it is political to its core and the psychiatric profession must at least acknowledge the flames. Denise McKenna is mental health survivor and activist.
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Post by Admin on Dec 7, 2020 20:06:17 GMT
No Mental Health Without Human Rightsmadinasia.org/2020/07/no-mental-health-without-human-rights-an-analysis-of-the-un-special-rapporteurs-recent-report/Since the last few months, the world has been witnessing increasingly challenging times on various fronts, triggered in part by the COVID-19 pandemic. There have been, and continue to be, numerous instances of violence and injustice against the vulnerable and the marginalised. It is also important to add here that most of this violence has been an everyday reality for scores of people around the world since even before the pandemic. However, the mishandling of the pandemic by various governments has only added to those instances manyfold. In these times of crises, it has become even more imperative to foreground conversations and measures focused on the promotion and protection of all human rights. In this light, we are delighted to see that the latest report by the UN Special Rapporteur (SR), Dr Dainius Pūras, adopted in the 44th session of the Human Rights Council of the United Nations is distinctive in declaring that, “There is no mental health without human rights”. In this new report, he calls for worldwide measures to ensure the “right of everyone to the enjoyment of the highest attainable standard of physical and mental health.” Dr Pūras has previously appealed for the need to “abandon the predominant medical model that seeks to cure individuals by targeting ‘disorders.'” In this new report, he presses upon the importance of the “promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development”. This report is also perhaps the document most strongly endorsing the UNCRPD. He urges us to look at how the Movement for Global Mental Health (previously known as Global Mental Health) is framed and delivered because it will have a huge impact on whether human rights are upheld or not. The Movement for Global Mental Health (MGMH) aims to scale up access to mental health services, and to a wider field of advocacy, activism and research, including critical perspectives. The fact that the SR is referring to a better framing ensuring human rights tells us that there are areas for concern in the way the MGMH is currently being delivered and needs thought and change. In addition, he speaks about the need to critically assess which policies may work in certain areas and contexts and that we can’t simply ‘export’ advocacy strategies and other literature from the Global North to the South. He stresses the importance of moving away from standardisation for global mental health, “while standardization is important for global work, it also overlooks understanding and practices that resist standardization owing to complexity or locality.” As user-survivors from the Asia Pacific region, it is of utmost significance for us that global guidelines are not universally applied to our context, without due consideration given to our social realities. The SR suggests: A rights-based pathway to achieving more local relevance in global mental health might be to move away from evidence-based practice to practice-based evidence, which takes as its starting point local realities, possibilities and understanding of care. Research shows that mental health system reform in fragile and conflict-affected areas emerges through creative practices, experimentation, adaptation and the application of knowledge, as people deal with uncertainty and complexity in contexts where fundamental resources are sometimes lacking. This is exciting for us because it puts rights at the forefront of all action while asking us to move from evidence-based (read medical) to practice-based (read community-led, local) evidence. The SR quotes TCI Asia Pacific’s Bali Declaration of 2018 that “affirmed the need for a paradigm shift in mental health towards inclusion and away from a focus dominated by the medical model” and was similar to the approach shared by other organisations such as Mental Health Europe. Several organisations share this advocacy approach about moving towards non-medical alternatives and these voices add to the global conversation asking for a shift from more medical services to other culturally relevant, community-focused, and trauma-informed means of enhancing what health may mean to individuals. The SR’s report firmly states that human rights violations, perpetuating coercion, stigma and discrimination against persons with disabilities, are all still happening due to practices existing within the field of mental health and that it is imperative to work towards changing these oppressive structures. Mental health systems worldwide are dominated by a reductionist biomedical model that uses medicalization to justify coercion as a systemic practice and qualifies the diverse human responses to harmful underlying and social determinants (such as inequalities, discrimination and violence) as “disorders” that need treatment. In such a context, the main principles of the Convention on the Rights of Persons with Disabilities are actively undermined and neglected. This approach ignores evidence that effective investments should target populations, relationships and other determinants, rather than individuals and their brains. It is commendable that the report engages with the power imbalance entrenched in the mental health space and the importance of “the participation of persons with mental health conditions, including persons with disabilities, in the planning, monitoring and evaluation of services, in system strengthening and in research.” The combination of a dominant biomedical model, power asymmetries and the wide use of coercive practices together keep not only people with mental health conditions, but also the entire field of mental health, hostage to outdated and ineffective systems. States and other stakeholders, specifically the professional group of psychiatry, should critically reflect on this situation and join forces already on the way towards abandoning the legacy of systems based on discrimination, exclusion and coercion. The SR cautions against “over-medicalisation” while reflecting on the labels that are assigned based on “enforced boundaries around normal or acceptable behaviours and experiences.” He affirms that medicalised responses to social exclusion and discrimination “can often disproportionately affect individuals who face social, economic or racial marginalisation.” Medicalization can mask the ability to locate one’s self and experiences within a social context, fuelling misrecognition of legitimate sources of distress (health determinants, collective trauma) and producing alienation. In practice, when experiences and problems are seen as medical rather than social, political or existential, responses are centred around individual-level interventions that aim to return an individual to a level of functioning within a social system rather than addressing the legacies of suffering and the change required to counter that suffering at the social level. Moreover, medicalization risks legitimizing coercive practices that violate human rights and may further entrench discrimination against groups already in a marginalized situation throughout their lifetimes and across generations. He, thus, appeals to move away from “individual-level interventions” by critically reflecting on the exclusionary and discriminatory social structures that cause distress. This is an important point, one that urges us to stop looking at individuals through an illness lens, from a what is wrong with you lens, to a societal lens – what may have happened to make this individual feel or react this way? This is exciting to us at Mad in Asia Pacific where we work to bring awareness to this social justice model. In order to prevent mass medicalization, it is essential to embed a human rights framework in the conceptualization of, and policies for, mental health. The importance of critical thinking (for example, learning about the strengths and weaknesses of a biomedical model) and knowledge of the importance of a human rights-based approach and the determinants of health must be a central part of medical education. The SR acknowledges that mental health-care systems and institutions are failing and that there are other approaches to look at the right to health. He looks towards innovative community projects that focus on building strength and resilience in the communities, allowing for diversity, and acceptance of varying versions of ‘normal’. Several sections of the report also emphasise the importance of engaging with persons with lived experience and ask for the acceptance of diverse communities with a variety of experiences. Action that focuses only on strengthening failing mental health-care systems and institutions is not compliant with the right to health. The locus of the action must be recalibrated to strengthen communities and expand evidence-based practice that reflects a diversity of experiences. He demands an “immediate scaling-up of rights-based, non-coercive alternatives” that are “occurring in neighbourhoods and communities worldwide” operating with a “deep commitment to human rights, dignity and non-coercive practices, all of which remain an elusive challenge in traditional mental health systems too heavily reliant on a biomedical paradigm.” The SR also urges for critical and sustained engagement with factors like climate change, digital surveillance and the current COVID-19 pandemic situation and their effects on global mental health. He writes that the “emotional and existential realization of the magnitude of the climate problem” is increasingly being experienced particularly by children and young people. Additionally, he talks about the curtailment of people’s rights and the significant harm that “non-transparent surveillance” of people by State or non-State actors can bring to people’s mental health. Finally, the SR concludes the report with a set of important conclusions and recommendations, firmly declaring that “There is no health without mental health and there is no good mental health and well-being without embracing a human rights-based approach”. The report’s holistic and interdisciplinary engagement with mental health fills us with immense hope about a more just and equitable world and we at Mad in Asia Pacific fully endorse it. You can download the Word and PDF versions of the full report in English and several other languages here. Drafted with inputs from Jhilmil Breckenridge. undocs.org/en/A/HRC/44/48
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